how do YOU deal with unruly patients?

[pie123]

Nothing.

[Tweety, BSN, RN]

Sometimes you limit set. Sometimes you walk out the door. Sometimes you surrender and you just take it for the sake of getting through your shift.

Sometimes that "therapuetic communication" you learn in school works. Other times it's laughable when you say to a patient "you sound angry, is anything going on...."

I try not to take it personally. I try to see why they are acting that way. Maybe it's a control issue, maybe they are in pain, but sometimes they are idiot jerks not worth me getting upset over.

The Jekle and Hyde personalities when it comes to dealing with doctors and how they treat nurses can be very irritating.

Good luck!

[TraumaQueen]

Sometimes, people are just jerks. Sometimes, they need attention, even if it's negative.

I've been known to give a short lecture about respecting your healthcare worker. I had a patient, whom I cared for very very well, tell me to F-off, amongst other various vulgarities. I calmly explained to him that I was taking very good care of him, that I understand that he's uncomfortable and in pain, but that if he works with me, we can try to get him better..... and for the rest of the night, he was quite pleasant.

One night, I floated to a med/surg floor and one of my patients wanted to go outside with her oxygen to smoke.... I wouldn't let her, and she punched me... I had a bruise and everything. I told her, go smoke, I can't stop you, but you're not taking the O2. She called me EVERY name she could think of, went back to bed, and then sweetly called me into the room to ask, "Can I please have my pain pills?"

With the bypass patients, I've learned that if you get them to understand what you're doing to try and get their pain under control, they lighten up a lot..... I'm also very aggressive with them, and they'll be up in a chair 30 minutes post-extubation, doing breathing exercises and coughing. I always thought they'd hate me, but it seems like the more aggressive I am with them, to help them get better, the more pleasant they are!

And yanno, there are just some patients where you have to throw up your hands and do your best to not lose your temper.

But, deep down you can wish for a cartoon sized mallet, or a 200 foot long piece of duct tape, or to be able to say.... "Don't piss me off, I control your pain medication!" :)

[Marie_LPN, RN, LPN, RN]

I remind myself that they are probably angry at the world right now and not take it personally.

[live4today, RN]

Usually.........an unruly patient is only acting out feelings they find difficult to put into words. If they are usually independent by nature prior to admission, they are frustrated because they are now wearing an awful hospital gown, sharing a room with a stranger, and having strange healthcare workers poke and prod them, question them about things they normally keep private, and are embarrassed because they are having to depend on someone else to do things for them.

When a patient is admitted to the hospital, they pretty much are placed at the mercy of others day in and day out. Not a comfortable place to be at all.

Give good eye contact, and let them know you care about them and will give them as much independence as reasonably possible while still providing them with the care they need to get better.

I have found that therapeutic communication works wonders on most patients. :)

[nyapa, RN]

Originally posted by LPN2Be2004

I remind myself that they are probably angry at the world right now and not take it personally.

The nurse is expected to stand back and take it? Even more so, why does the nurse expect him/herself to accept abuse? We have a physical and verbal abuse policy. Three strikes and youre discharged. Yeah right! Looks pretty on paper... Rarely happens. You can document until you are blue in the face...noone cares, All they have done here is created extra paperwork. Instead of documenting in the patients notes, you now have to complete an incident form, and an abuse form as well. I would like to list a heap of incidences...but that would be breaching confidentiality. No one cares, except for your colleagues and cosufferers

[Marie_LPN, RN, LPN, RN]

Originally posted by dar15

The nurse is expected to stand back and take it? Even more so, why does the nurse expect him/herself to accept abuse? We have a physical and verbal abuse policy. Three strikes and youre discharged. Yeah right! Looks pretty on paper... Rarely happens. You can document until you are blue in the face...noone cares, All they have done here is created extra paperwork. Instead of documenting in the patients notes, you now have to complete an incident form, and an abuse form as well. I would like to list a heap of incidences...but that would be breaching confidentiality. No one cares, except for your colleagues and cosufferers

Where in my post did i say that a nurse has to sit back and take it? ( I ask, because you quoted me.)

[sharann, BSN, RN]

If a pt says not to touch the dressing...that the dr will do it, I will say "Sure sir/madam, if you want to REFUSE to allow me to monitor your wound for infection or bleeding, then you are within your rights to wait the 12 to 24 hours for the doctor to come...if it's not too late by then"

Hey, I am a nurse, not a mommy to a rotten person. If they are angry, I try to be understanding, but I will not be abused by anyone. IF they don't want us to touch them, don't. Now they call it assault and battery.

[nyapa, RN]

Originally posted by LPN2Be2004

Where in my post did i say that a nurse has to sit back and take it? ( I ask, because you quoted me.)

Well you said not to take it personally. I interpreted that to mean that it was ok for ppl to have a go at us...we just have to be understanding about it.

[Grant Morgan]

I thing that being a guy helps just a bit because we don't seem to take the crap. (i stand to be corrected) If a patient is rude I'll ask him:

"is it necessary to be so rude?" in a way that is just a little judgemental.

Then I'll tell them :

" we treat you with dignity and respect, and i think that we desreve the same."

That works most of the time, but you'll still get the idiot with the big ego, in that case tell him you'll come back when he has cooled off........because you can't work with rude people.

Hope this helps, but working with people, you will always get the good side & the bad side of things, it will never change unless you stop the abuse. Whatever happened to assertiveness???????

[dragonfly954]

It is not realistic or desirable for us to have to take harsh words from patients,but sometimes it is out of our control and can't be avoided.Perhaps it is their only means of controlling an out of control situation( serious unexpected illness and hospitalization).I enlightened a foursome of screaming fire-medics that didn't want to take the 85 year old puking drunk driver with crushing chest pain to the er at 12 am on christmas eve because(according to them) he was fine and was only having an anxiety attack and they didn't want to do the run report--they were politely reminded that they chose the job, it didn't choose them.

[jschut, BSN, RN]

The other night, I was called every name in the book by a patient. ALL night long....

She would stand up, look over the desk where I was trying to get my work done, adn yell at me to do this or to do that, and to do it NOW!

I walked away, tried to ignore her, I even went down and smoked a cigarette (I quit 6 months ago...)

Pt wouldn't go to bed, insisted that I make her something to eat, but yet refused everything I offered.....

It was her medication, but boy, was I stressed when I got off that morning! Boy, was I stressed!

(PS: Prednisone effected her bi-polar staus....)